Dear Dr Ombeva,
My son developed boils on his feet and hands then I pressed them and things came out crawling, like fat whitish worms. I was told those are maggots. The baby has no fever or any other sign of illness. I am so worried. What can I do?
Answer
Thank you for your question. The whitish fat short worms coming from your baby’s skin are called maggots and your baby is suffering from a disease called myiasis.
Myiasis is the parasitic infestation of the body of a live animal by fly larvae (maggots) that grow inside the tissue. While flies often are attracted to open wounds, some can lay eggs and infect unbroken skin. This includes botfly, blowfly and screw fly.
This infection is also common in livestock as well. It may affect skin, eyes, ears, stomach and intestinal tract, or in genitourinary sites. Some larvae or eggs enter the body through the nose or ears.
Larvae or eggs can reach the stomach or intestines if swallowed with food and cause gastric or intestinal myiasis. Affecting the skin, it causes painful, slow-developing ulcers or boil-like sores that can last for a prolonged period.
In the nose, it can cause obstruction of nasal passages and severe irritation. The face may swell with oedema, and fever may occur. In the ear, it may cause ear discharge and buzzing ear noise. In eyes, it may cause severe irritation, oedema, and pain.
Because it is rare, myiasis is often misdiagnosed, but the occurrence of one or more non-healing boils on the skin, itchiness, movement under the skin or pain, discharge from a central punctum (tiny hole), or a small, white structure protruding from the lesion.
It is controlled through prevention and eradication of flies or early treatment for both humans and affected livestock. Spraying has also been used to control fly population.
In general, improvement of sanitation, personal hygiene, and eradication of flies by insecticides is important.
Clothes should be washed thoroughly, preferably in hot water, dried away from flies, and ironed thoroughly. The heat of the iron kills the eggs of myiasis-causing flies.
The drug of choice is ivermectin. Other measures include applying petroleum on the holes suffocates and forces the larvae onto the surface.
Dr Ombeva Malande is a specialist paediatrician
ombevaom@gmail.com